|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$2.16
|
|
|
Service Code
|
NDC 68084009711
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$2.16 |
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: ASR ASR |
$2.09
|
| Rate for Payer: BCBS Trust/PPO |
$1.77
|
| Rate for Payer: BCN Commercial |
$1.77
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cofinity Commercial |
$2.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.73
|
| Rate for Payer: Healthscope Commercial |
$2.09
|
| Rate for Payer: Healthscope Whirlpool |
$2.16
|
| Rate for Payer: Mclaren Commercial |
$1.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.83
|
| Rate for Payer: Nomi Health Commercial |
$1.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.90
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$2.16
|
|
|
Service Code
|
NDC 68084009711
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$2.16 |
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: Aetna Medicare |
$0.80
|
| Rate for Payer: ASR ASR |
$2.09
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.78
|
| Rate for Payer: BCN Commercial |
$1.78
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cofinity Commercial |
$2.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.73
|
| Rate for Payer: Healthscope Commercial |
$2.09
|
| Rate for Payer: Healthscope Whirlpool |
$2.16
|
| Rate for Payer: Mclaren Commercial |
$1.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.83
|
| Rate for Payer: Nomi Health Commercial |
$1.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1.89
|
| Rate for Payer: Priority Health Narrow Network |
$1.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.90
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$215.65
|
|
|
Service Code
|
NDC 68084009701
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.74 |
| Max. Negotiated Rate |
$215.65 |
| Rate for Payer: Aetna Commercial |
$194.09
|
| Rate for Payer: ASR ASR |
$209.18
|
| Rate for Payer: BCBS Trust/PPO |
$177.09
|
| Rate for Payer: BCN Commercial |
$177.09
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Commercial |
$202.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$209.18
|
| Rate for Payer: Healthscope Whirlpool |
$215.65
|
| Rate for Payer: Mclaren Commercial |
$194.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Nomi Health Commercial |
$176.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$189.77
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$215.03
|
|
|
Service Code
|
NDC 904629006
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.27 |
| Max. Negotiated Rate |
$215.03 |
| Rate for Payer: Aetna Commercial |
$193.52
|
| Rate for Payer: ASR ASR |
$208.57
|
| Rate for Payer: BCBS Trust/PPO |
$176.58
|
| Rate for Payer: BCN Commercial |
$176.58
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Commercial |
$202.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Healthscope Commercial |
$208.57
|
| Rate for Payer: Healthscope Whirlpool |
$215.03
|
| Rate for Payer: Mclaren Commercial |
$193.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.77
|
| Rate for Payer: Nomi Health Commercial |
$176.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$189.22
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$195.70
|
|
|
Service Code
|
NDC 904629061
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$146.78 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna Commercial |
$176.13
|
| Rate for Payer: ASR ASR |
$189.83
|
| Rate for Payer: BCBS Trust/PPO |
$160.71
|
| Rate for Payer: BCN Commercial |
$160.71
|
| Rate for Payer: Cash Price |
$156.56
|
| Rate for Payer: Cofinity Commercial |
$183.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.56
|
| Rate for Payer: Healthscope Commercial |
$189.83
|
| Rate for Payer: Healthscope Whirlpool |
$195.70
|
| Rate for Payer: Mclaren Commercial |
$176.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: Nomi Health Commercial |
$160.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$172.22
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$1.92
|
|
|
Service Code
|
NDC 50268009311
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$1.92 |
| Rate for Payer: Aetna Commercial |
$1.73
|
| Rate for Payer: ASR ASR |
$1.86
|
| Rate for Payer: BCBS Trust/PPO |
$1.58
|
| Rate for Payer: BCN Commercial |
$1.58
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Commercial |
$1.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.86
|
| Rate for Payer: Healthscope Whirlpool |
$1.92
|
| Rate for Payer: Mclaren Commercial |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Nomi Health Commercial |
$1.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.69
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$2.49
|
|
|
Service Code
|
NDC 68084009911
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$2.49 |
| Rate for Payer: Aetna Commercial |
$2.24
|
| Rate for Payer: ASR ASR |
$2.41
|
| Rate for Payer: BCBS Trust/PPO |
$2.04
|
| Rate for Payer: BCN Commercial |
$2.04
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Healthscope Whirlpool |
$2.49
|
| Rate for Payer: Mclaren Commercial |
$2.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Nomi Health Commercial |
$2.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.19
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$385.70
|
|
|
Service Code
|
NDC 51079021020
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.71 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Aetna Commercial |
$347.13
|
| Rate for Payer: Aetna Medicare |
$142.71
|
| Rate for Payer: ASR ASR |
$374.13
|
| Rate for Payer: BCBS Complete |
$154.28
|
| Rate for Payer: BCBS Trust/PPO |
$318.01
|
| Rate for Payer: BCN Commercial |
$318.01
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Commercial |
$362.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$374.13
|
| Rate for Payer: Healthscope Whirlpool |
$385.70
|
| Rate for Payer: Mclaren Commercial |
$347.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.85
|
| Rate for Payer: Nomi Health Commercial |
$316.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$337.95
|
| Rate for Payer: Priority Health Narrow Network |
$270.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.42
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$248.90
|
|
|
Service Code
|
NDC 68084009901
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.09 |
| Max. Negotiated Rate |
$248.90 |
| Rate for Payer: Aetna Commercial |
$224.01
|
| Rate for Payer: Aetna Medicare |
$92.09
|
| Rate for Payer: ASR ASR |
$241.43
|
| Rate for Payer: BCBS Complete |
$99.56
|
| Rate for Payer: BCBS Trust/PPO |
$205.22
|
| Rate for Payer: BCN Commercial |
$205.22
|
| Rate for Payer: Cash Price |
$199.12
|
| Rate for Payer: Cofinity Commercial |
$233.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.12
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Healthscope Whirlpool |
$248.90
|
| Rate for Payer: Mclaren Commercial |
$224.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$199.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.56
|
| Rate for Payer: Nomi Health Commercial |
$204.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$218.09
|
| Rate for Payer: Priority Health Narrow Network |
$174.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.03
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$3.86 |
| Rate for Payer: Aetna Commercial |
$3.47
|
| Rate for Payer: ASR ASR |
$3.74
|
| Rate for Payer: BCBS Trust/PPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Commercial |
$3.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Healthscope Whirlpool |
$3.86
|
| Rate for Payer: Mclaren Commercial |
$3.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Nomi Health Commercial |
$3.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.39
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$226.10
|
|
|
Service Code
|
NDC 904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.66 |
| Max. Negotiated Rate |
$226.10 |
| Rate for Payer: Aetna Commercial |
$203.49
|
| Rate for Payer: Aetna Medicare |
$83.66
|
| Rate for Payer: ASR ASR |
$219.32
|
| Rate for Payer: BCBS Complete |
$90.44
|
| Rate for Payer: BCBS Trust/PPO |
$186.42
|
| Rate for Payer: BCN Commercial |
$186.42
|
| Rate for Payer: Cash Price |
$180.88
|
| Rate for Payer: Cofinity Commercial |
$212.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.88
|
| Rate for Payer: Healthscope Commercial |
$219.32
|
| Rate for Payer: Healthscope Whirlpool |
$226.10
|
| Rate for Payer: Mclaren Commercial |
$203.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Nomi Health Commercial |
$185.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$198.11
|
| Rate for Payer: Priority Health Narrow Network |
$158.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.97
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$385.70
|
|
|
Service Code
|
NDC 51079021020
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$289.27 |
| Max. Negotiated Rate |
$385.70 |
| Rate for Payer: Aetna Commercial |
$347.13
|
| Rate for Payer: ASR ASR |
$374.13
|
| Rate for Payer: BCBS Trust/PPO |
$316.74
|
| Rate for Payer: BCN Commercial |
$316.74
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Commercial |
$362.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$374.13
|
| Rate for Payer: Healthscope Whirlpool |
$385.70
|
| Rate for Payer: Mclaren Commercial |
$347.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.85
|
| Rate for Payer: Nomi Health Commercial |
$316.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$339.42
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$248.90
|
|
|
Service Code
|
NDC 68084009901
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$186.68 |
| Max. Negotiated Rate |
$248.90 |
| Rate for Payer: Aetna Commercial |
$224.01
|
| Rate for Payer: ASR ASR |
$241.43
|
| Rate for Payer: BCBS Trust/PPO |
$204.40
|
| Rate for Payer: BCN Commercial |
$204.40
|
| Rate for Payer: Cash Price |
$199.12
|
| Rate for Payer: Cofinity Commercial |
$233.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.12
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Healthscope Whirlpool |
$248.90
|
| Rate for Payer: Mclaren Commercial |
$224.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.56
|
| Rate for Payer: Nomi Health Commercial |
$204.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$186.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.03
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$3.86 |
| Rate for Payer: Aetna Commercial |
$3.47
|
| Rate for Payer: Aetna Medicare |
$1.43
|
| Rate for Payer: ASR ASR |
$3.74
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: BCBS Trust/PPO |
$3.18
|
| Rate for Payer: BCN Commercial |
$3.18
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Commercial |
$3.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Healthscope Whirlpool |
$3.86
|
| Rate for Payer: Mclaren Commercial |
$3.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Nomi Health Commercial |
$3.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.38
|
| Rate for Payer: Priority Health Narrow Network |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.39
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$2.49
|
|
|
Service Code
|
NDC 68084009911
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$2.49 |
| Rate for Payer: Aetna Commercial |
$2.24
|
| Rate for Payer: Aetna Medicare |
$0.92
|
| Rate for Payer: ASR ASR |
$2.41
|
| Rate for Payer: BCBS Complete |
$1.00
|
| Rate for Payer: BCBS Trust/PPO |
$2.05
|
| Rate for Payer: BCN Commercial |
$2.05
|
| Rate for Payer: Cash Price |
$1.99
|
| Rate for Payer: Cofinity Commercial |
$2.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.99
|
| Rate for Payer: Healthscope Commercial |
$2.41
|
| Rate for Payer: Healthscope Whirlpool |
$2.49
|
| Rate for Payer: Mclaren Commercial |
$2.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.12
|
| Rate for Payer: Nomi Health Commercial |
$2.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.18
|
| Rate for Payer: Priority Health Narrow Network |
$1.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.19
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$226.10
|
|
|
Service Code
|
NDC 904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.57 |
| Max. Negotiated Rate |
$226.10 |
| Rate for Payer: Aetna Commercial |
$203.49
|
| Rate for Payer: ASR ASR |
$219.32
|
| Rate for Payer: BCBS Trust/PPO |
$185.67
|
| Rate for Payer: BCN Commercial |
$185.67
|
| Rate for Payer: Cash Price |
$180.88
|
| Rate for Payer: Cofinity Commercial |
$212.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.88
|
| Rate for Payer: Healthscope Commercial |
$219.32
|
| Rate for Payer: Healthscope Whirlpool |
$226.10
|
| Rate for Payer: Mclaren Commercial |
$203.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Nomi Health Commercial |
$185.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$198.97
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$40.41
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.30 |
| Max. Negotiated Rate |
$40.41 |
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Commercial |
$32.60
|
| Rate for Payer: Aetna Commercial |
$38.97
|
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: ASR ASR |
$42.00
|
| Rate for Payer: ASR ASR |
$39.19
|
| Rate for Payer: ASR ASR |
$35.14
|
| Rate for Payer: ASR ASR |
$27.24
|
| Rate for Payer: BCBS Trust/PPO |
$33.18
|
| Rate for Payer: BCBS Trust/PPO |
$23.06
|
| Rate for Payer: BCBS Trust/PPO |
$29.75
|
| Rate for Payer: BCBS Trust/PPO |
$35.56
|
| Rate for Payer: BCN Commercial |
$23.06
|
| Rate for Payer: BCN Commercial |
$35.56
|
| Rate for Payer: BCN Commercial |
$29.75
|
| Rate for Payer: BCN Commercial |
$33.18
|
| Rate for Payer: Cash Price |
$34.64
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cofinity Commercial |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.46
|
| Rate for Payer: Healthscope Commercial |
$39.19
|
| Rate for Payer: Healthscope Commercial |
$27.24
|
| Rate for Payer: Healthscope Commercial |
$35.14
|
| Rate for Payer: Healthscope Commercial |
$42.00
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Healthscope Whirlpool |
$43.30
|
| Rate for Payer: Healthscope Whirlpool |
$28.08
|
| Rate for Payer: Healthscope Whirlpool |
$36.22
|
| Rate for Payer: Mclaren Commercial |
$25.27
|
| Rate for Payer: Mclaren Commercial |
$38.97
|
| Rate for Payer: Mclaren Commercial |
$32.60
|
| Rate for Payer: Mclaren Commercial |
$36.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.87
|
| Rate for Payer: Nomi Health Commercial |
$29.70
|
| Rate for Payer: Nomi Health Commercial |
$35.51
|
| Rate for Payer: Nomi Health Commercial |
$33.13
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.10
|
|
|
ATROPINE 0.1 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$43.30
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
730
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$43.30 |
| Rate for Payer: Aetna Commercial |
$38.97
|
| Rate for Payer: Aetna Commercial |
$32.60
|
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Commercial |
$25.27
|
| Rate for Payer: Aetna Medicare |
$10.39
|
| Rate for Payer: Aetna Medicare |
$16.02
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: ASR ASR |
$39.19
|
| Rate for Payer: ASR ASR |
$35.14
|
| Rate for Payer: ASR ASR |
$27.24
|
| Rate for Payer: ASR ASR |
$42.00
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS Complete |
$11.23
|
| Rate for Payer: BCBS Complete |
$17.32
|
| Rate for Payer: BCBS Complete |
$14.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.87
|
| Rate for Payer: BCBS Trust/PPO |
$35.70
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCBS Trust/PPO |
$23.15
|
| Rate for Payer: BCN Commercial |
$35.70
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: BCN Commercial |
$23.15
|
| Rate for Payer: BCN Commercial |
$29.87
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cash Price |
$34.64
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$28.98
|
| Rate for Payer: Cash Price |
$22.46
|
| Rate for Payer: Cash Price |
$34.64
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cofinity Commercial |
$40.70
|
| Rate for Payer: Cofinity Commercial |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.32
|
| Rate for Payer: Healthscope Commercial |
$42.00
|
| Rate for Payer: Healthscope Commercial |
$27.24
|
| Rate for Payer: Healthscope Commercial |
$35.14
|
| Rate for Payer: Healthscope Commercial |
$39.19
|
| Rate for Payer: Healthscope Whirlpool |
$28.08
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Healthscope Whirlpool |
$43.30
|
| Rate for Payer: Healthscope Whirlpool |
$36.22
|
| Rate for Payer: Mclaren Commercial |
$36.37
|
| Rate for Payer: Mclaren Commercial |
$32.60
|
| Rate for Payer: Mclaren Commercial |
$25.27
|
| Rate for Payer: Mclaren Commercial |
$38.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.80
|
| Rate for Payer: Nomi Health Commercial |
$23.03
|
| Rate for Payer: Nomi Health Commercial |
$33.13
|
| Rate for Payer: Nomi Health Commercial |
$35.51
|
| Rate for Payer: Nomi Health Commercial |
$29.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.88
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$40.41
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$40.41 |
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Medicare |
$14.95
|
| Rate for Payer: ASR ASR |
$39.19
|
| Rate for Payer: BCBS Complete |
$16.16
|
| Rate for Payer: BCBS Trust/PPO |
$33.31
|
| Rate for Payer: BCN Commercial |
$33.31
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cofinity Commercial |
$37.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.32
|
| Rate for Payer: Healthscope Commercial |
$39.19
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Mclaren Commercial |
$36.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Nomi Health Commercial |
$33.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.56
|
|
|
ATROPINE 0.1 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$40.41
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
163701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.30 |
| Max. Negotiated Rate |
$40.41 |
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: ASR ASR |
$39.19
|
| Rate for Payer: BCBS Trust/PPO |
$33.18
|
| Rate for Payer: BCN Commercial |
$33.18
|
| Rate for Payer: Cash Price |
$32.32
|
| Rate for Payer: Cofinity Commercial |
$37.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.32
|
| Rate for Payer: Healthscope Commercial |
$39.19
|
| Rate for Payer: Healthscope Whirlpool |
$40.41
|
| Rate for Payer: Mclaren Commercial |
$36.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.35
|
| Rate for Payer: Nomi Health Commercial |
$33.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.56
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
IP
|
$65.10
|
|
|
Service Code
|
NDC 70069058201
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.83 |
| Max. Negotiated Rate |
$65.10 |
| Rate for Payer: Aetna Commercial |
$58.59
|
| Rate for Payer: ASR ASR |
$63.15
|
| Rate for Payer: BCBS Trust/PPO |
$53.46
|
| Rate for Payer: BCN Commercial |
$53.46
|
| Rate for Payer: Cash Price |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$61.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.08
|
| Rate for Payer: Healthscope Commercial |
$63.15
|
| Rate for Payer: Healthscope Whirlpool |
$65.10
|
| Rate for Payer: Mclaren Commercial |
$58.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.34
|
| Rate for Payer: Nomi Health Commercial |
$53.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.29
|
|
|
ATROPINE 1 % EYE DROPS
|
Facility
|
OP
|
$65.10
|
|
|
Service Code
|
NDC 70069058201
|
| Hospital Charge Code |
736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$65.10 |
| Rate for Payer: Aetna Commercial |
$58.59
|
| Rate for Payer: Aetna Medicare |
$24.09
|
| Rate for Payer: ASR ASR |
$63.15
|
| Rate for Payer: BCBS Complete |
$26.04
|
| Rate for Payer: BCBS Trust/PPO |
$53.67
|
| Rate for Payer: BCN Commercial |
$53.67
|
| Rate for Payer: Cash Price |
$52.08
|
| Rate for Payer: Cofinity Commercial |
$61.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.08
|
| Rate for Payer: Healthscope Commercial |
$63.15
|
| Rate for Payer: Healthscope Whirlpool |
$65.10
|
| Rate for Payer: Mclaren Commercial |
$58.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.34
|
| Rate for Payer: Nomi Health Commercial |
$53.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$57.04
|
| Rate for Payer: Priority Health Narrow Network |
$45.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$57.29
|
|
|
ATROPINE 1 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
IP
|
$30.96
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301597
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.22 |
| Max. Negotiated Rate |
$30.96 |
| Rate for Payer: Aetna Commercial |
$27.86
|
| Rate for Payer: ASR ASR |
$30.03
|
| Rate for Payer: BCBS Trust/PPO |
$25.42
|
| Rate for Payer: BCN Commercial |
$25.42
|
| Rate for Payer: Cash Price |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$29.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.77
|
| Rate for Payer: Healthscope Commercial |
$30.03
|
| Rate for Payer: Healthscope Whirlpool |
$30.96
|
| Rate for Payer: Mclaren Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.32
|
| Rate for Payer: Nomi Health Commercial |
$25.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.24
|
|
|
ATROPINE 1 MG/ML INJECTION SOLUTION WRAPPER
|
Facility
|
OP
|
$30.96
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
301597
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$30.96 |
| Rate for Payer: Aetna Commercial |
$27.86
|
| Rate for Payer: Aetna Medicare |
$11.45
|
| Rate for Payer: ASR ASR |
$30.03
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$25.53
|
| Rate for Payer: BCN Commercial |
$25.53
|
| Rate for Payer: Cash Price |
$24.77
|
| Rate for Payer: Cash Price |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$29.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.77
|
| Rate for Payer: Healthscope Commercial |
$30.03
|
| Rate for Payer: Healthscope Whirlpool |
$30.96
|
| Rate for Payer: Mclaren Commercial |
$27.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.32
|
| Rate for Payer: Nomi Health Commercial |
$25.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.11
|
| Rate for Payer: Priority Health Narrow Network |
$0.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.24
|
|
|
ATROPINE 1 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$30.96
|
|
|
Service Code
|
HCPCS J0462
|
| Hospital Charge Code |
195981
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$30.96 |
| Rate for Payer: Aetna Commercial |
$27.86
|
| Rate for Payer: Aetna Medicare |
$11.45
|
| Rate for Payer: ASR ASR |
$30.03
|
| Rate for Payer: BCBS Complete |
$12.38
|
| Rate for Payer: BCBS Trust/PPO |
$25.53
|
| Rate for Payer: BCN Commercial |
$25.53
|
| Rate for Payer: Cash Price |
$24.77
|
| Rate for Payer: Cash Price |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$29.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.77
|
| Rate for Payer: Healthscope Commercial |
$30.03
|
| Rate for Payer: Healthscope Whirlpool |
$30.96
|
| Rate for Payer: Mclaren Commercial |
$27.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.32
|
| Rate for Payer: Nomi Health Commercial |
$25.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$0.14
|
| Rate for Payer: Priority Health Narrow Network |
$0.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.24
|
|
